Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China.
Research Department, Swiss University of Traditional Chinese Medicine, Bad Zurzach, Switzerland.
Int J Clin Pract. 2023 Dec 18;2023:9504108. doi: 10.1155/2023/9504108. eCollection 2023.
Management of chronic coronary syndrome (CCS) encompasses a broad spectrum of practices, posing considerable complexity and variability. While guidelines have been established to augment the management quality of CCS, notable disparities persist across their recommendations. This study strives to scrutinize, compare, and reconcile these guideline recommendations pertaining to the diagnosis, treatment, and management of CCS patients. Our goal is to align these recommendations with contemporary clinical practices, thus laying a robust foundation for their pragmatic application in clinical settings.
A comprehensive systematic search was conducted across multiple databases, including PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, Chinese Biomedical Literature Service System, Chinese Science and Technology Periodical Database, and Chinese Biological Medicine Database. The timeframe for this search spanned from their inception up to May 30, 2022, aiming to collate all published guidelines relevant to CCS. Subsequently, two independent reviewers undertook the task of appraising the quality of these guidelines by utilizing the Appraisal of Guidelines for Research and Evaluation II instrument.
The search yielded a total of 10,699 citations. Following a thorough evaluation, fourteen clinical practice guidelines and four consensus statements, each offering specific recommendations for CCS, were selected. The quality of these guidelines showcased a broad spectrum of variation. The domain of "presentation clarity" received the highest accolades, while "applicability" languished at the lower end of the scoring spectrum. On average, the guidelines attained a quality score denoting sufficiency. Furthermore, recommendations across different guidelines for the diagnosis, treatment, and management of CCS displayed a striking level of divergence.
The landscape of published CCS guidelines is marked by extensive variations in scope, quality, and recommendations. Hence, there is a compelling need for collaborative efforts amongst multidisciplinary professionals to forge comprehensive, higher-quality evidence-based guidelines; such a concerted approach is paramount to enhance treatment efficacy and health outcomes for patients grappling with CCS.
慢性冠状动脉综合征（CCS）的管理涵盖了广泛的实践范围，具有相当大的复杂性和可变性。虽然已经制定了指南来提高 CCS 的管理质量，但它们的建议仍然存在显著差异。本研究旨在仔细审查、比较和协调这些与 CCS 患者的诊断、治疗和管理相关的指南建议。我们的目标是使这些建议与当代临床实践保持一致，从而为它们在临床环境中的实际应用奠定坚实的基础。
我们在多个数据库中进行了全面的系统检索，包括 PubMed、EMBASE、中国知识基础设施、万方数据库、中国科技期刊数据库、中国生物医学文献服务系统、中国科技期刊数据库和中国生物医学数据库。这个搜索的时间范围从它们的开始到 2022 年 5 月 30 日，旨在收集所有与 CCS 相关的已发表指南。然后，两名独立的审查员使用评估研究和评估 II 工具对这些指南的质量进行了评估。
搜索共产生了 10699 条引文。经过仔细评估，选择了 14 项临床实践指南和 4 项共识声明，每个指南都为 CCS 提供了具体的建议。这些指南的质量显示出广泛的变化。“表现清晰度”领域获得了最高的赞誉，而“适用性”则处于评分范围的低端。平均而言，指南获得了表示充足性的质量评分。此外，不同指南对 CCS 的诊断、治疗和管理的建议显示出惊人的分歧。
已发表的 CCS 指南的情况表明，在范围、质量和建议方面存在广泛的差异。因此，多学科专业人员之间需要进行协作，制定全面、高质量的基于证据的指南；这种协调一致的方法对于提高治疗效果和改善患有 CCS 的患者的健康结果至关重要。
